All the World's a Stage

He sits slumped in his chair, hair streaked with a gray that is almost dirty, a rime of age showing on a weathered head. His movements are erratic, jerky, as if he can't quite decide what he his telling himself to do. He is still wearing his sunglasses, but seems to have forgotten that, constantly reaching up to rub his eyes and starting in quick surprise. The red bulb of his nose gives away his alcoholism, an unfortunate beacon of failure and difficulty.

We ask him his name once, and after a brief pause, he informs us that he goes by the handle of Woody. He tells us a story then, about how he got the nickname because he used to love woodworking when he was younger, he used to make wooden chairs. We ask what brought him to the hospital, but all he will say is that he is sick. We ask him about his youth, his interestingly offbeat habit of carpentry, but he looks at us blankly, slight confusion in his eyes. We ask him his name again, and he looks directly at my badge before responding: "Tom."

He came in two weeks ago, having been picked up by the police for a drunk and disorderly. He was confused, and walking erratically even after the drunk wore off, so they brought him into the hospital. They hoped it was just Wernicke's Encephalopathy, a temporary condition brought on by an alcoholics tendency to substitute beer for bread, so they hooked him into a supply of vitamin B12. It didn't help. He has Korsakoff's Psychosis, a permanent damage to the titillatingly named mamillary bodies of the hypothalamus, the two round protuberances of the bottom of his brain. The damage is done by a long term lack of B12, a crucial compound for biological functions from energy metabolism to oxidative damage protection. He must have spent years trading his daily bread for booze, depleting his bodies stores of this crucial resource.

His disease has robbed him of himself, and of his future self. He has amnesia, anterograde and retrograde, forwards and backwards. Its a bad case. He doesn't know who he was, what he was. He wont remember this interview for long. It comes with confabulation, the remarkable ability to develop a semi-coherent story based on minimal cues. He became Woody based on the wooden chairs in the office (actually a molded wood-stain plastic, but who wanted to argue). He developed a whole story about his youth, based only on one visual cue. His life is bound eternally in the now, constantly redefined as he sees fit, according to a logic that no one will ever know.

We tell him his real name, and he responds like he has known that all along, glossing over the stories of the past few minutes as if they had never been uttered. Of course, to him, they hadn't.